A Career Chapter · Karachi, Pakistan
Where the nights were long, the wards were demanding, and every shift deepened a clinical fluency that textbooks alone could never have taught me.
From October 2014 to February 2019, I served as Night RMO at the Institute of Behavioral Sciences — a dedicated psychiatric and drug rehabilitation center in Karachi. What began as a door opened by a mentor became one of the most formative and defining chapters of my clinical life.
The Connection
Head of Department of Psychiatry, Civil Hospital Karachi — one of Pakistan's most distinguished senior psychiatrists. His generosity in allowing extended clinical attachment, and his quiet recommendation that changed a career trajectory.
Professor of Psychiatry Civil Hospital Karachi MentorI had been conducting clinical attachments under Professor Raza-ur-Rehman at Civil Hospital Karachi — a privilege extended with characteristic warmth by one of Pakistan's most respected psychiatrists, who had made it clear that the attachment could continue for as long as it was useful. It was during this period that I was also preparing for the MRCP Psychiatry Part 1 examination, and the question of covering educational expenses naturally arose.
When I mentioned this to Professor Raza-ur-Rehman, he did not hesitate. He mentioned a Relieving RMO position at the Institute of Behavioral Sciences (IBS) — a well-regarded psychiatric and drug rehabilitation center — and suggested it might suit. There was only one practical concern: IBS was far from where I lived, and at the time I relied entirely on public transport.
"It was far from where I lived and at the time I had no car — only public transport. When Professor Raza-ur-Rehman asked how I would manage the distance, my answer was simple: I'll manage."
And manage I did — beginning what would become five years of near-continuous presence at IBS, arriving by public transport through Karachi's evenings, and returning home only for a few hours of rest before the next shift began.
I arrived at IBS, met the institution's administrator — Madam Shahla Ahmed — and was then interviewed by Professor Sohail, the institute's senior clinical lead. Madam Shahla Ahmed's role in the process was far more than procedural. As the administrative backbone of the institute, it was her judgment, her eye for character, and her decision to move the process forward that opened this chapter for me.
Her significance in my tenure at IBS cannot be overstated. She was the person who facilitated my entry, who navigated the institutional formalities, and whose confidence in me made the subsequent offer — and all the years that followed — possible. In the quiet arithmetic of a career, some people tip the scales. Madam Shahla Ahmed was one of those people.
I began working at IBS from 1st October 2014, taking on duties independently whenever and whatever time was required — evenings, nights, weekends, public holidays.
Key Figure
Administrator, IBS — the institutional anchor whose professionalism and confidence in me made this chapter possible. Her role extended well beyond administration; she shaped the culture of welcome and integrity that defined my life at IBS.
Administrator IBS Instrumental FigureWithin months of joining, management offered me a fixed position as Night RMO — a testament to the trust I had already earned. I accepted. What followed was a schedule that would define the next five years.
Every weekday evening, I was at IBS. Six nights a week, through Karachi's heat, rains, and restless city rhythms — I was there.
On Sundays and all gazetted public holidays, my duties extended to full 24-hour shifts for which overtime was provided. Days off were not really days off.
Home became the place for a few hours of sleep and essential chores. By evening, I was back. The hospital became, in every practical sense, where I lived.
From the moment a patient arrived at their most acute and vulnerable point, through the long arc of stabilisation and early recovery — I was present for all of it, night after night.
The Institute
A dedicated psychiatric and drug rehabilitation center in Karachi. Named in honour of Dr. Abdul Qadeer Khan, Pakistan's celebrated nuclear scientist and co-founder — the institute carries a legacy of scientific distinction alongside its clinical mission.
Psychiatry Drug Rehabilitation Behavioral SciencesIBS serves patients across the full spectrum of psychiatric illness and substance dependence — a complex, demanding patient population that requires not just clinical knowledge but an entirely different register of human presence. Over five years, spending more hours inside the hospital than outside it, I developed a depth of psychiatric clinical fluency that cannot be acquired in any other way.
I learned to read the gradations of acute psychiatric presentation — to distinguish, in the early hours of a night shift, the precise stage of a patient's crisis, and to calibrate my response accordingly. I became fluent in the language of recovery: its rhythms, its setbacks, its quiet milestones. I understood, from repeated lived experience, how a person looks at the worst point of admission — and how they look weeks later.
Spending whole nights with patients from the moment of admission at their worst point through the early stages of recovery — that is not clinical exposure. That is clinical formation.
My capacity to interact with mentally ill patients and those in addiction recovery, to recognize the subtle factors that precipitate relapse, and to provide emergency psychiatric intervention in real time — all of this was shaped during these five years at IBS.
Distinguished Recognition
Among the most distinguished recognitions of my career, I received a personal Letter of Appreciation from Dr. Abdul Qadeer Khan — Pakistan's celebrated nuclear scientist and co-founder of the Institute of Behavioral Sciences — in recognition of my exceptional and dedicated services at IBS. A letter from one of Pakistan's most towering national figures, acknowledging the quiet commitment of a physician who chose to show up, night after night, for five years.
Referring Mentor
Professor & Head of Psychiatry · Civil Hospital Karachi
One of Pakistan's foremost senior psychiatrists, whose generosity with clinical access and whose quiet recommendation opened the door to IBS for me. A mentor who shaped not only my clinical thinking but my professional path itself.
Administrator & Key Enabler
Administrator · Institute of Behavioral Sciences
The institutional anchor of IBS whose professionalism and confidence in me made this entire chapter possible. Her significance in facilitating my joining and supporting my tenure remains a defining element of this story.
Clinical Interviewer & Senior Lead
Senior Clinical Lead · Institute of Behavioral Sciences
The senior clinical authority at IBS under whose institutional oversight I was formally appointed and served throughout my tenure — providing the clinical leadership framework within which five years of night duty took shape.
My tenure at IBS concluded in February 2019 — on entirely good terms, with mutual respect and the quiet satisfaction of work done with integrity over five demanding years. The clinical depth I gained here continues to inform every patient encounter that has followed.